PharmacoEconomics - Modern pharmacoeconomics and pharmacoepidemiology (E-Journal) / ФАРМАКОЭКОНОМИКА. Современная фармакоэкономика и фармакоэпидемиология
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Систематический обзор эффективности Пентаглобина в предотвращении смертности от любых причин при бактериальных инфекциях и сепсисе у детей до двух лет
Get PDFObjectives. There is no consistent evidence of clinical efficacy of Pentaglobin for reducing mortality in newborns and older children with bacterial infections and sepsis. The aim of the study was to update evidence by considering recent clinical trials and analyzing age populations and comparators separately.Methods. We searched publications in PubMed and the Cochrane Library in December 2014 and in October 2015. All-cause mortality was analyzed, and systematic review using meta-analysis and indirect comparison was carried out.Results. Three meta-analyses and 7RCTs were considered, including 6 trials studied the effect of Pentaglobin in newborns, and one in children 1-24 months old. All interventions were applied with basic therapy (BT). In newborns mortality is lower in Pentaglobin than in all comparators groups, RR 0.51 [0.32; 0.82], and in BT with or without placebo, RR 0.56 [0.34; 0.91]. Children under 24 months receiving Pentaglobin also had lower mortality than in all comparators group, RR 0.51 [0.36; 0.72]. Indirect comparison of IgM and IgG in adults showed no differences, in newborns the difference is in favor of IgM, RR 0.51 [0.32; 0.82].Conclusion. Pentaglobin is effective in reducing all-cause mortality in newborns with bacterial infection or sepsis in comparison with any comparators (BT with or without placebo, albumin, IgG), in children under 24 months in comparison to BT with or without albumin. Further head-to-head clinical trials are needed to enhance evidence
Оценка рациональности затрат на лечение тяжелой внебольничной пневмонии в условиях многопрофильног о стационара
Get PDFPurpose — to study rationality of financial expenses on the treatment of patients with the severe pneumonia.Materials and methods. It was selected 30 medical histories of patients with severe community-acquires pneumonia passing hospitalization in pulmonology department and department of intensive care in 2004, 2011 and 2014. The frequency analysis was applied to studying the structure of the carried-out drug treatment and identification of frequency of the separate medicinal preparations. We have data about the cost of drug which were received from the database of «1C: Drugstore» of regional clinical hospital.Results. Expenses on the treatment of severe community-acquires pneumonia according to 2014 year are rational, 92.23% of expenses are vitally necessary drug entering into modern clinical references. According to the ABC/VEN analysis during the period from 2004 till 2014 we found positive dynamics of increase of expenditure of money at category V. The appreciable attention should be paid to the treatment of accompanying pathology in the therapy of severe communityacquires pneumonia which can make heavier a current of basic disease and become the reason of complications, often fatal. Costs of the medicinal preparations for treatment of the accompanying pathology in 2014 year was made 6.27% that it is necessary to consider at advance planning of provision of medicines in pulmonology department.Conclusion. The results received by us testify about rational use of financial costs on treatment of patients with severe community-acquires pneumonia
Фармакоэкономическое обоснование применения препарата Ленвима® (ленватиниб) при прогрессирующем дифференцированном раке щитовидной железы, рефрактерном к радиоактивному йоду, в Российской Федерации
Get PDFObjective: to conduct a pharmacoeconomic analysis of lenvatinib (Lenvima) in advanced progressive radio iodine refractory differentiated thyroid cancer in the Russian Federation.Methods. Cost-effectiveness ratio (CER) and budget impact analysis (BIA) were performed. All calculations were made in the MS Excel model. CER compared lenvatinib 24 mg/daily, sorafenib 800 mg/daily and Other chemotherapies mix. BIA compared two scenarios: 1) common practice consisting of sorafenib and Other chemotherapies mix; 2) new practice where lenvatinib is used in 6.25% patients. Costs of drugs, visits to oncologist and hospitalization were calculated both in CER and BIA. Time horizon was 2 years for CER and 5 years for BIA.Results. Lenvatinib is a new highly effective target drug for the monotherapy of the radioiodine refractory differentiated thyroid cancer. Lenvatinib significantly increases progression free survival, thus providing in the proposed model, 1628 additional years of life for patients per 5 years. Additional costs at the same time constitute 5 213 900 000 rub. (670.5 to 1184.3 million rubles per year). Calculated unit lenvatinib efficiency stands at 64.95% less than that of the comparisons targeted drug (sorafenib)
Оценка эффективности региональных расходов на здравоохранение в России
Get PDFLife expectancy to healthcare spending ratio differs significantly among the Russian regions. The differences could be explained with both non-discretionary factors and the regional management efficiency. The main aim of this article is to evaluate the efficiency of the regional healthcare in Russia employing the formal methodological approach. We use three-step data envelopment analysis (DEA) in order to (1) calculate the technical efficiency scores for regional healthcare systems, (2) determine non-discretionary factors affecting the scores and (3) exclude the non-discretionary component from scores to asses the management efficiency. Using data for 76 Russian regions in 2006-2013 we found approx. 27% regional healthcare spending inefficient, which equals to real 269-435 billion rubles of inefficient spending annually.
Клинико-экономическое исследование использования препаратов из группы агонистов рецепторов тромбопоэтина в терапии хронической идиопатической тромбоцитопенической пурпуры у взрослых
Get PDFСтоимость лечения метастатического колоректального рака во второй и последующих линиях терапии с использованием таргетных препаратов
Get PDFTargeted drugs are recommended for treatment of metastatic colorectal cancer. Second and further lines therapy options include anti-EGFR therapy, eligible for patients with wild-type KRAS (cetuximab and panitumumab), and relatively new drug — regorafenib, which could be used for all patients.The aim of this study is to compare costs associated with these options in Russia.Materials and methods. We calculated cost of medication for treating one patient during one month with cetuximab, panitumumab and regorafenib. We also employed cost-effectiveness analysis, but its results should be treated with caution due to non-comparable patients in regorafenib and anti-EGRF drugs studies.Results. We found that monthly per patient medication costs of using regorafenib are 255,000 rubles, which is 104,000 rubles less when using cetuximab or 184,000 rubles less when using panitumumab. Cost-effectiveness ratio for regorafenib was estimated at 111,500 rubles per month and is the lowest among the alternatives: 136,000 rubles per month for cetuximab and 310,000 rubles per month for panitumumab.Conclusions. Regorafenib is cost-saving alternative for treatment of metastatic colorectal cancer in second and further lines therapy compared to cetuximab and panitumumab in Russia
Управленческий аспект проблемы использования наркотических лекарственных средств
Get PDFThe use of narcotic drugs in healthcare system nowadays is characterized by lawful aspects prevalence over medical, bioethics, economic and social aspects. The paper highlights the management imbalance in the system of record and control of narcotic drugs and suggests using in its decision real management tools: functional and process approaches as well as balance score card. The operation definition will allow to identify the ineffective phases, functional overlaps and basic losses in the process of narcotic drugs turnover while balance score card implementation will help to reveal the anticipatory indexes of efficient use of such medication.Использование наркотических лекарственных средств (НЛС) в здравоохранении в настоящее время характеризуется наличием определенных «перекосов», связанных с превалированием правового аспекта в ущерб медицинскому, биоэтическому, экономическому, социальному и другим. Авторы выделяют в проблеме очевидный управленческий дисбаланс, касающийся существующей системы учета и контроля НЛС, и предлагают опираться в ее решении на практические инструменты менеджмента: функциональный и процессный подходы, а также систему сбалансированных показателей. Так, конкретизация операций позволит выявить неэффективные, узкие места, дублирование функций и основные потери в процессах оборота НЛС, а применение системы сбалансированных показателей — определить опережающие индикаторы рационального использования данной группы препаратов
Перспективы применения методов клинико-экономического анализа на этапе планирования и организации клинических исследований
Get PDFThe article describes a new approach to the use of economic evaluation at the stage of planning and organization of clinical trials and considers the examples of studies which undertook this approach. The use of economic evaluation before clinical trials enables to assess the necessity of undertaking of the clinical trial and formulate the recommendations regarding the appropriate trial design, increasing its costeffectiveness.В статье описывается новый подход по применению клинико-экономического анализа на этапе планирования клинических исследований, а также приводятся примеры исследований, реализовавших данный подход. Применение методов клинико-экономического анализа на этапе планирования позволяет оценить целесообразность и необходимость проведения клинического исследования, а также дать рекомендации по оптимальному дизайну исследования для достижения максимальной экономической эффективности и снижению затрат на проведение
ФАРМАКОЭКОНОМИЧЕСКОЕ ИССЛЕДОВАНИЕ ПРИМЕНЕНИЯ ЭВЕРОЛИМУСА ДЛЯ ИММУНОСУПРЕССИВНОЙ ТЕРАПИИ ПОСЛЕ ПЕРЕСАДКИ ПОЧКИ
Get PDFObjective: to calculate cost difference between two approaches for immunosuppressive therapy after renal transplantation: everolimus plus reducedexposure cyclosporine and mycophenolic acid plus standard-exposure cyclosporine. Methods. We calculated the two-year difference in costs that resulted from effectiveness and safety differences of alternatives employing the probability-statistical model. Data on safety and efficiency were taken from D. Cibrik et al. (2013) randomized control trial. We also estimated the budget impact for everolimus inclusion into 7 expensive diseases program (7EDP). 7 EDP is the special federal program of drug provision for patients suffering from 7 certain diseases and health states including organ posttransplantation period. Results. Everolimus plus reduced-exposure cyclosporine leads to cost reduction by 161 RUB thousands (17%) per patient in a two-year period. The reduction mainly results from cheaper medication in everolimus plus reduced-exposure cyclosporine approach compared to mycophenolic acid plus standard-exposure cyclosporine. Everolimus inclusion into 7 expensive diseases program leads to reduction in federal budget spending starting from the first year; the total five-year budget savings are 275 RUB millions.
БАЗОВАЯ МОДЕЛЬ ОЦЕНКИ ТЕХНОЛОГИЙ ЗДРАВООХРАНЕНИЯ
No full textThe EUnetHTA Core Model is an electronic system of standardized health technology assessment, currently under development by EUnetHTA. The system is designed to be used within the EUnetHTA program countries (which include Austria, Belgium, Denmark, Finland, Bulgaria, Croatia, Cyprus, Czech Republic, Estonia and others). The Core Model software is currently under development, along with research and reporting methods. The HTA Core Model aim is to create a single database on health technologies, which might be used for new technologies assessment wherever the program is applicable. HTA Core Model is based on the principal of dividing given information into standardized thematic chapters, organized from common to precise. By this, a common assessment technology for any health technology is created to make possible a maximum precise compartment of competing technologies by selected key values. Research, made by the HTA Core Model, are unified, and are mostly designed for health technology assessment in EU zone. For utilizing in healthcare environment beyond EU, they may be localized (completely or partly, depending on local healthcare detail).Базовая Модель ОТЗ – система стандартизированной оценки технологий здравоохранения (ОТЗ), разрабатываемая Европейской сетью организации по оценке медицинских технологий. Изначально система приспособлена для работы в странах участницах программы Европейской сети организации по оценке медицинских технологий (в их числе Австрия, Бельгия, Дания, Финляндия, Болгария, Хорватия, Кипр, Чехия, Эстония и др.). Программное обеспечение Базовой Модели все еще находится в процессе разработки, как и методика проведения исследований и записи результатов. Цель Базовой Модели ОТЗ – создать значительную единую базу данных по существующим технологиям здравоохранения, которую можно было бы использовать для оценки новых технологий в любой точке охваченной программой территории. В основе Базовой модели ОТЗ лежит принцип разделения исходной и получаемой информации на стандартные тематические блоки, подразделяемые по размеру от общего к частному. Таким образом, создается единая для любых ТЗ технология оценки, делающая возможным максимально объективное сравнение конкурирующих технологий по выбранным ключевым параметрам. Исследования, проведенные с помощью Базовой Модели ОТЗ, являются унифицированными, и, в первую очередь, предназначены для оценки ТЗ в Европейской зоне. Для использования в средах здравоохранения за пределами ЕС исследования Базовой Модели ОТЗ могут быть локализованы (полностью или частично, в зависимости от условий местного здравоохранения)